Provider Demographics
NPI:1679960876
Name:CASQUARELLI, ELAINE JOYCE (MED, EDS, LMHC)
Entity type:Individual
Prefix:MS
First Name:ELAINE
Middle Name:JOYCE
Last Name:CASQUARELLI
Suffix:
Gender:F
Credentials:MED, EDS, LMHC
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:63 SOCKANOSSET CROSS RD # 2A-4
Mailing Address - Street 2:
Mailing Address - City:CRANSTON
Mailing Address - State:RI
Mailing Address - Zip Code:02920-5557
Mailing Address - Country:US
Mailing Address - Phone:505-490-5600
Mailing Address - Fax:
Practice Address - Street 1:63 SOCKANOSSET CROSS RD STE 2A-4
Practice Address - Street 2:
Practice Address - City:CRANSTON
Practice Address - State:RI
Practice Address - Zip Code:02920-5557
Practice Address - Country:US
Practice Address - Phone:505-490-5600
Practice Address - Fax:
Is Sole Proprietor?:No
Enumeration Date:2015-04-25
Last Update Date:2024-04-12
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
NMCCMH0209151101YM0800X
RIMHC01592101YM0800X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes101YM0800XBehavioral Health & Social Service ProvidersCounselorMental Health